Fruits and vegetables

Suggested

5 studies · 1 recommendation

Last updated: February 25, 2026

Suggested5 studies

Higher fruit and vegetable intake linked to reduced breast cancer risk and recurrence

Five studies encompassing over 8,400 participants consistently associate greater fruit and vegetable consumption with lower breast cancer risk and improved outcomes. A case-control study (1093 cases, 2118 controls) found a healthy lifestyle index including fruit and vegetable intake reduced postmenopausal breast cancer odds by 53% (OR 0.47, 95% CI 0.23–0.94). Mediterranean dietary patterns rich in fruits and vegetables cut overall breast cancer risk by 44% (OR 0.56, 95% CI 0.40–0.79) and triple-negative breast cancer risk by 68% (OR 0.32). Among 3,081 survivors, diets low in fruits and vegetables (high acid load) more than doubled recurrence risk (HR 2.15–2.31) in those with elevated HbA1c. An expert consensus identified strong evidence for tumor-inhibiting compounds in produce, including carotenoids, polyphenols, and isothiocyanates functioning as antioxidants. Clinical guidelines recommend at least 5 daily portions of fruits and vegetables for breast cancer survivors.

Evidence

Hemoglobin A1c Levels Modify Associations between Dietary Acid Load and Breast Cancer Recurrence.

Authors: Hsu, Fang-Chi, Luong, David, Pierce, John P, Wang, Shunran, Wu, Tianying

Published: February 1, 2020

In 3,081 breast cancer survivors studied over 7.3 years, dietary acid load measured by PRAL and NEAP scores showed strong positive associations with cancer recurrence when HbA1c was ≥5.6%. Women in the highest quartile of acid load had more than double the recurrence risk compared to the lowest quartile (HR 2.15 and 2.31 respectively). The PRAL score factors in the alkaline contributions of fruits and vegetables against acid-forming protein and phosphorus, suggesting dietary shifts toward alkaline foods may be protective.

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Spanish Mediterranean diet and other dietary patterns and breast cancer risk: case–control EpiGEICAM study

Authors: A Castelló, A de Juan-Ferré, A Goldhirsch, A Lluch, A M Casas, A Paul, A Ruiz, A Trichopoulou, AA Davis, AC Wolff, AH Wu, B Buijsse, B Pérez-Gómez, B Yang, C Jara, C Pelucchi, CA Demetriou, E Carrasco, E De Stefani, E Díaz, FB Hu, G Buckland, G Grosso, H Barkoukis, H Boeing, HD Woo, I Romieu, IR White, J Ferlay, J M Baena-Cañada, J Vioque, J Vioque, J Vioque, JS Zheng, KJ Lee, L Baglietto, LJ Martin, LM Butler, Lukas Schwingshackl, M A Jimeno, M de Lorgeril, M Martín, M Muñoz, M Pollán, M Ramos, MA Murtaugh, ME Hammond, N Garcia-Arenzana, N Garcia-Arenzana, P Rosado, P Royston, PF Jacques, RL Prentice, S Antolín, SF Brennan, T Agurs-Collins, TT Fung, V Cottet, V Edefonti, V Guillem, V Lope, WC Willett, X Cui

Published: January 1, 2014

In this case-control study of 1017 incident breast cancer cases and 1017 matched healthy controls in Spain, high adherence to the Mediterranean dietary pattern (top vs bottom quartile) was associated with a 44% lower risk of breast cancer (OR=0.56; 95% CI 0.40–0.79). The protective effect was strongest for triple-negative tumours (OR=0.32; 95% CI 0.15–0.66; P-heterogeneity=0.04). The Mediterranean pattern was characterized by high intake of fruits, vegetables, legumes, oily fish, and vegetable oils. The Alternate Healthy Index also showed a protective association (OR=0.69; 95% CI 0.51–0.94 for top vs bottom quartile).

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Healthy lifestyle and risk of breast cancer for indigenous and non-indigenous women in New Zealand: a case control study.

Authors: Ellison-Loschmann, Lis, Firestone, Ridvan, Jeffreys, Mona, McKenzie, Fiona, Pearce, Neil, Romieu, Isabelle

Published: January 1, 2014

A population-based case-control study (1093 cases, 2118 controls) in New Zealand built an eleven-factor healthy lifestyle index score including fruit and vegetable consumption. Among postmenopausal Māori women, the top HLIS tertile was associated with significantly reduced breast cancer odds (OR 0.47, 95% CI 0.23-0.94) compared to the bottom tertile. The HLIS ranged from 1-9 for Māori and 1.5-10.5 for non-Māori, with equal weighting given to each factor.

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Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment

Authors: A Campbell, A McTiernan, A McTiernan, A Silvestri, A Visser, AB Kornblith, AC Utter, AH Wu, AJ Daley, Amanda Daley, AN Dentino, AS Fairey, AT Beck, B Dugue, B Rockhill, B Zumoff, BL Andersen, BL Gruber, BL Stauffer, BM Pinto, BS McEwen, C Peters, C Peters, C Wiltschke, CB Ebbeling, CL Caldwell, CM Bryla, CM Friedenreich, D Geffken, D Nerozzi, DC McMillan, DC Nieman, DC Nieman, DC Nieman, DC Nieman, DC Nieman, DC Nieman, DF Cella, DG Cruess, DH Bovbjerg, DM Golden-Kreutz, DV Schapira, DW Kissane, E Maunsell, EA Bermudez, G Borg, G van der Pompe, G van der Pompe, GG Kolden, H Davis, H Kervinen, HC Abercrombie, Helen Crank, Hilary Powers, HV Thomas, J Gallagher, J Kaukua, J Verloop, JA Cauley, JE Bower, JE Epping-Jordan, JF Sallis, JK Camoriano, JK Smith, JO Prochaska, John M Saxton, JR Calabrese, JS Goodwin, KL Jen, KM Rexrode, KS Courneya, KS Madden, L Bernstein, L Chang, M Maes, M Maes, M Maes, M Mezzetti, MD Gammon, MD Holmes, MD Holmes, ME Nelson, MK Baldwin, N Banu, Nanette Mutrie, Nicola Woodroofe, PJ Goodwin, RJ Benschop, Robert Coleman, RT Chlebowski, S Cohen, S Levy, S Yamasaki, SE Hankinson, SE Sephton, SI Mannering, SJ Schleifer, SJH Biddle, SK Lutgendorf, SM Levy, T Moradi, T Treasure, TA Wadden, TP Erlinger, U Ehlert, Vanessa Siddall, Y Touitou, Y Touitou, Z Djuric, Z Kronfol

Published: January 1, 2006

In a randomized controlled trial enrolling 100 breast cancer survivors, the lifestyle intervention group receives individualized dietary advice that includes consuming at least 5 portions of fruit and vegetables per day. This dietary recommendation is part of a comprehensive 24-week intervention that also targets fat reduction to ~25% of calories, increased fiber, reduced refined carbohydrates, and moderate alcohol intake. The trial measures effects on body weight, psychological health, and biomarkers associated with disease recurrence and survival.

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Report from the working group on diet and cancer.

Authors: Adami, Hans-Olov, Dragsted, Lars, Enig, Bent, Hansen, Jens, Haraldsdóttir, Jóhanna, Hill, Michael J., Holm, Lars Erik, Knudsen, Ib, Larsen, Jens-Jorgen, Lutz, Werner K., Osler, Merete, Overvad, Kim, Sabroe, Svend, Sanner, Tore, Sorensen, Thorkild I. A., Strube, Michael, Thorling, Eivind B.

Published: January 1, 1993

The ECP working group consensus characterized evidence for the beneficial effects of fruits and vegetables as strong across multiple cancer types. Identified tumor-inhibiting compounds include vitamins (ascorbic acid, tocopherols, carotenoids) and phytochemicals (isothiocyanates, dithiothiones, flavones, indoles, polyphenols, terpenes, allylsulphides). Many cancer-protective agents function as antioxidants or stimulate natural antioxidation mechanisms. The Danish population had moderate to low levels of protective antioxidant factors including selenium, ascorbates, tocopherols, and beta-carotene, with only a small increase in fruit and vegetable consumption since 1975. Oxidative damage to the genome from natural cellular processes exceeds 10,000 adducts per cell per day.

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